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Stretch and spray therapy is one of the popular and effective treatment methods used in the management of myofascial pain syndromes and myofascial trigger points in muscles; hence so will be effective the myofascial component of the thoracic outlet syndrome. Vapocoolants are used in the spray, the two most commonly used are ethyl chloride and Fluori Methane sprays. The sequence of steps used in the stretch and spray of any muscle for myofascial trigger point is as follows.

Patient is supported in a comfortable relaxed position. One end of muscle is anchored. Skin is sprayed with rapid parallel sweeps of vapocoolant over the length of muscle in the direction of pain pattern. All of the muscle is covered. Immediately after the first sweep of spray, pressure is applied to stretch the muscle and is continued as spray is applied. Sweeps of spray are continued to cover the referred pain pattern of that muscle. All this is repeated two to three times or less if the passive range of motion becomes maximum. Hot pack and several cycles of active full range of motion follows.